When one spouse applies for Medicaid benefits in order to fund long-term healthcare, the other spouse is often referred to as the “healthy spouse” or the “community spouse.” If you know anything about Medicaid benefits, you know that protecting your assets from Medicaid recovery is typically a concern, this concern grows when there is a healthy spouse involved. Let our Charlotte Medicaid attorney explain strategies for protecting the healthy spouse while applying for Medicaid benefits.
Medicaid Issues that Affect the Healthy Spouse
If your spouse was applying for Medicaid to pay for long-term care and you were still living at home, you are referred to as the community spouse or healthy spouse. Because of the asset and income limits, there are certain provisions in place to provide minimal protections for the community spouse. One of them is the monthly maintenance needs allowance. Under the rules of the Medicaid program, most of the income that is due to the institutionalized spouse must be used to help defray the long-term care costs. However, some of that income and a good portion of the couple’s assets may be available to the healthy spouse so discuss your options with our Charlotte Medicaid attorney.
How the Medicaid Benefits Program Works
The Medicaid program is a health insurance program that is jointly administered by the federal government along with each respective state government. Most people are aware that Medicaid is in place to help people who have very limited resources. If you work throughout your life, you earn retirement credits, and you will qualify for Medicare when you reach the age of 65. This can lead to the belief that all of your health care needs will be covered when you obtain Medicare eligibility. That may not be the case, as our Charlotte Medicaid attorney often explains.
Medicare Alone Will Not Cover the Cost of Nursing Home Care
Medicare will provide you with broad coverage. However, there is a very big potential expense that Medicare will not cover. The Medicare program will pay for part of up to 100 days of convalescent care after a three-day hospital admission, but it will not pay for custodial care. This is the type of care that you would receive if you were to reside in a nursing home.
Nursing homes are extremely expensive all around the country. People often spend multiple years receiving care, with the average being just over two years according to a relatively recent government survey. Medicaid does pay for long-term care, and this is why many people who were never financially needy find that the program is relevant to them at some point in time.
Medicaid Planning is Important for You and Your Family
When you are budgeting for the future, you should certainly be aware of potential long-term care costs. It can be hard to wrap your head around a time when you will no longer be able to handle all of your own day-to-day needs. Statisticians tell us that most American seniors will eventually require living assistance. Long-term care is very expensive. For many, Medicaid is the solution because Medicare won’t pay for long-term care.
However, not everything that you own counts when Medicaid is evaluating your eligibility. And a couple often has options for preserving assets for the community spouse during the Medicaid spend down process.
The Medicaid Community Spouse Resource Allowance
Since Medicaid is intended for people with financial need, there is a $2000 limit on countable assets. However, if you are married, your spouse is entitled to a Community Spouse Resource Allowance. This allowance is equal to half of the countable assets that are shared by the couple in question. However, there is an upper limit. There is also a minimum Community Spouse Resource Allowance. This is the amount that the healthy spouse can keep, even if it is more than half of the shared countable assets. In addition to the Community Spouse Resource Allowance, our Charlotte Medicaid attorney can often assist couples in preserving additional assets the community spouse needs to live on.
The Medicaid Monthly Maintenance Needs Allowance
If the community spouse is relying on the other spouse’s income to maintain a minimal standard of living, the community spouse may be entitled to a monthly maintenance needs allowance. Income that would have otherwise gone toward the cost of care can be retained by the healthy spouse. There is a maximum Medicaid monthly maintenance needs allowance for each state, which may change each year.
If you have questions regarding various Medicaid benefits or any other Medicaid planning matters, please contact the experienced attorneys at The Potter Law Firm for a consultation. You can contact us either online or by calling us at (704) 944-3245 (Charlotte, NC or Huntersville, NC) or for individuals in Kentucky at (606) 324-5516 (Ashland, KY) or at (859) 372-6655 (Florence, KY).
John’s practice focuses on the use of Wills and Living Trusts in Estate Planning to help individuals protect their families and preserve their legacies after their deaths, but his practice also focuses on the critical issues of protecting individuals with dementia or other diminished capacity, assisting individuals in qualifying for Medicaid and other government benefits to offset the costs of long-term care, and providing special needs planning.
John is admitted to practice law in North Carolina, South Carolina, Kentucky, and Ohio, and he is accredited by the Department of Veterans Affairs.
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